The Allon Barsam episode

In episode 12 of The OT Podcast, we speak to consultant ophthalmologist, Allon Barsam. We talk to Allon about his career as an ophthalmologist; from the moment of clarity that set him on the pathway to ophthalmology, to his decisions on sub-specialities over the years, which include laser refractive surgery, cataract surgery with advanced technology lenses, and corneal surgery.

Here are three things we learned about Allon when recording The OT Podcast.

1 Allon made the decision to specialise in ophthalmology “rather late” following an experience with a patient in A&E

Allon explains that ophthalmology “has always been a competitive specialty,” with professionals battling it out for 80 places in England annually – “that is the bottle neck to get into ophthalmology.”

Due to how competitive entering the field can be, Allon believes most decide to embark on the pathway early on in their career, highlighting: “There are so many hoops to jump through in order to try and get into it. It’s not an open-door policy.”

As a medical student, he wanted to be a physician – a medical hospital doctor. It was a role that he found intellectually stimulating, describing it as “a bit like the medical equivalent to Sherlock Holmes.”

“You are piecing together little bits of information to try and work out what is wrong with a patient, and then you can apply the cure, the treatment,” he added.

However, by a twist of fate, during his final months of medical school, Allon found himself in the emergency department treating a patient who would change his medical pathway.

“I remember it very clearly. It was three or four months before I was due to qualify as a doctor. Someone had chatted up the wrong person’s girlfriend in a bar, and that person took exception and decided they would take a pitcher of beer and smash it in the guy’s face. He was cut from his forehead right through his face down across his lip and to his chin,” he told OT.

Recalling the 90 minutes Allon spent “putting stitches in the patient,” he shared: “I felt so connected with what I was doing. It was such a pure moment of problem, treatment and cure that I felt I couldn’t justify only doing a medical specialty… I should do a specialty where surgery forms a greater part of it.”

2 The consultant’s first cataract procedure was on a real patient

“The first time I did a full start to finish cataract operation was on a live, awake human patient – that’s the reality of it,” Allon shared. However, he described that “you start in steps, you do one bit and then the other, and then you go through and do the whole thing.”

Allon told OT: “I will never forget how much fear you feel when you are doing that [for the first time]. Even when you make your first incision, it feels so unnatural to take a blade and put it inside someone’s eyeball.”

Reassuring listeners, Allon shared that he believes all of “the best surgeons experience that emotion.”

“We all have varying degrees of emotional self-awareness and awareness of the impact of what we are doing on other people, and that’s important,” he adds.

3 The Last Samurai and the importance of reflection and rumination

For Allon, it is important for surgeons to reflect and ruminate on their work.

He recalls a scene from the 2003 Tom Cruise blockbuster, The Last Samurai, which he often tells trainees about: in the scene at the end of a fight, the samurai kneels down and meditates, replaying the fight and his sequences in his mind. During this reflection, he realises that one of the attackers, based on a strike sequence, is alive and standing behind him.

“The awareness of being reflective is really important for surgery,” Allon highlights.

While today, Allon says that that there are lots of ways and places for surgeons to record reflections, prior to this he would “ruminate.” This involved replaying surgical procedures in his mind and learning from his experiences.

The OT Podcast

OT will release a new episode of The OT Podcast bimonthly. You can listen to The OT Podcast on our website, or via all the main podcast apps, including Apple Podcasts, Spotify and Castbox. Be sure to catch-up and listen to other episodes, featuring experts including Imran Hakim, Ian Cameron, Dame Mary Perkins, and Professor Nicola Logan.

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